Individual
MS. SUSAN R BAUTISTA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
6767 OLD MADISON PIKE, SUITE 400 HGA HOME HEALTH, HUNTSVILLE, AL 35801
(256) 922-6650
(256) 922-6651
Mailing address
2089 CECIL ASHBURN DR SE, STE 202, HUNTSVILLE, AL 35802-2569
(256) 270-9922
(256) 270-9923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3746
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51519592
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/23/2006
Last updated
02/17/2021
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